cutting them short in their course, and the "expectant
treatment" followed as a natural consequence. It was a method of
managing disease rather than attempting to cure it. There was no
interference save to promote the patient's comfort, to nourish him as
thoroughly as might be without unduly taxing his powers, and to meet
complications as they arose. It was stooping to conquer, perhaps, but it
was a policy that conduced greatly to the well-being of the sick,
improved their chances of recovery, and enabled physicians to study
disease more accurately by reason of its course not being rendered
irregular by meddlesome medication. It has never been dropped, and it
never will be, save as such directly curative agents as the antitoxines
are made available.
In the early part of the century, except for gross anatomy and operative
surgery, medicine was taught almost wholly, so far as the schools were
concerned, by means of didactic lectures. The "drawing" capacity of a
professor was proportionate rather to his rhetorical powers and to the
persuasiveness with which he inculcated the views peculiar to himself
than to the amount of real information that he conveyed to the students.
Although the apprentice system--for that was what the practice of
students' attaching themselves to individual practitioners, whom they
called their preceptors, virtually amounted to--in many instances made
up more or less completely for the lack of systematic clinical teaching,
yet in the great majority of cases it amounted to little more than the
preceptor's allowing the student the use of his library and occasionally
examining into the latter's diligence and intelligence, in return for
which he, the preceptor, required an annual fee and exacted from the
student such minor services as his proficiency enabled him to render. It
is true the students "walked" the hospitals, drinking in some great
man's utterances, but they did it in droves, not a moiety of them being
able to get a good look at a patient, unless it was such a passing
glance as might tell them that the patient was jaundiced. By clinical
teaching we understand teaching, not in glittering generalities, but in
the concrete, either at the bedside, as the word _clinical_ originally
implied, or at least with the patient actually present to illustrate in
his person the professor's descriptions and the success or failure of
the treatment employed. The clinic is now firmly established, and has
been f
|